Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan.
Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan.
Clin Psychopharmacol Neurosci. 2013 Dec;11(3):132-6. doi: 10.9758/cpn.2013.11.3.132. Epub 2013 Dec 24.
Interest in the "at-risk mental state" (ARMS) for psychosis has increased because early intervention is expected to delay or prevent the onset of schizophrenia. However, the optimum intervention strategy remains controversial, especially with regard to antipsychotics. Although administration of antipsychotic medications is often associated with adverse effects and raises ethical considerations, recent studies have shown that some novel antipsychotics are safer and more tolerable for young people than conventional antipsychotics. We investigated whether administration of perospirone, a combined serotonin (5-HT)/dopamine antagonist and 5-HT1A receptor agonist, could alleviate prodromal symptoms and be well tolerated by clinical high risk patients.
The participants were outpatients seeking help. The Structured Interview for Prodromal Symptoms was performed in patients identified as being at clinical high risk. The Scale of Prodromal Symptoms (SOPS) was also completed and changes of subjective experience were assessed with the Subjective Well-being under Neuroleptics, short version. The incidence of akathisia was recorded by using the Barnes Akathisia Scale. Subjects were monitored for 26 weeks after starting medication.
SOPS scores improved significantly after 26 weeks of perospirone therapy, while BAS scores did not show deterioration. No serious adverse events occurred during the study.
This trial suggests that perospirone therapy provides a clinical benefit for clinical high risk subjects without causing serious adverse events. Although further placebo-controlled studies are needed for confirmation, perospirone might be one of optimum treatments for individuals at imminent risk of psychosis.
对精神病的“高危精神状态”（ARMS）的兴趣增加，因为早期干预有望延迟或预防精神分裂症的发作。然而，最佳的干预策略仍然存在争议，特别是在抗精神病药物方面。虽然抗精神病药物的使用通常与不良反应有关，并引起伦理考虑，但最近的研究表明，一些新型抗精神病药对年轻人比传统抗精神病药更安全、更耐受。我们研究了哌罗匹隆（一种联合 5-羟色胺（5-HT）/多巴胺拮抗剂和 5-HT1A 受体激动剂）的给药是否可以缓解前驱症状，并被临床高危患者耐受。
参与者为寻求帮助的门诊患者。在被确定为临床高危的患者中进行前驱症状的结构性访谈。还完成了前驱症状量表（SOPS），并使用抗精神病药物下的主观幸福感，短版评估主观体验的变化。使用巴恩斯静坐不能量表记录静坐不能的发生率。在开始用药后 26 周对受试者进行监测。
哌罗匹隆治疗 26 周后，SOPS 评分显著改善，而 BAS 评分没有恶化。研究过程中没有发生严重不良事件。
这项试验表明，哌罗匹隆治疗为临床高危患者提供了临床益处，而不会引起严重的不良事件。尽管需要进一步的安慰剂对照研究来证实，但哌罗匹隆可能是处于精神病高危状态的个体的最佳治疗方法之一。
